Detect Insulation Breach Using Electrogram Slope Analysis
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Solution Overview
Problem
Existing implantable medical devices (IMDs) face challenges in detecting short circuit conditions in medical electrical leads, which can occur intermittently and are not always detected by scheduled lead impedance measurements, potentially leading to inadequate therapy delivery during life-threatening conditions like ventricular fibrillation.
Innovation Solution
An IMD system that includes a controller configured to analyze cardiac electrical signals, such as intracardiac electrograms, to detect short circuit events by comparing the slope of the cardiac signal to a short circuit threshold, using sensing modules and therapy delivery modules to identify and respond to short circuit conditions, including adjusting impedance monitoring and selecting alternative therapy delivery pathways.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If scheduled lead impedance measurements are used to detect short circuit conditions, then the device can monitor lead integrity periodically, but intermittent short circuit events may be missed between measurement intervals
Solution Approach 1:
The patent implements continuous monitoring of cardiac electrical signals through electrogram analysis, replacing periodic impedance measurements with an ongoing detection process that operates throughout device function, ensuring no short circuit events are missed between measurement intervals
Solution Approach 2:
The patent substitutes electrical signal analysis (electrogram slope detection) for mechanical/electrical impedance measurement, using the naturally occurring cardiac electrical signals already present in the system rather than requiring separate diagnostic measurement procedures
2Speed
If the IMD continuously monitors cardiac signals for short circuit detection, then prompt detection of short circuit events is achieved, but device complexity and energy consumption increase
Solution Approach 1:
The patent extracts only the critical feature (signal slope) from the complex cardiac electrogram waveform, focusing detection on the specific characteristic that changes during short circuit events while ignoring other waveform features, thereby simplifying processing requirements
Solution Approach 2:
The patent changes the monitoring parameter from impedance (requiring separate measurement) to electrogram signal slope (using existing therapeutic signal pathways), enabling detection through analysis of an existing signal's temporal characteristics rather than requiring additional hardware or measurement systems
3Productivity
If the IMD delivers high voltage therapies without verifying lead integrity, then therapy delivery is uninterrupted, but battery drain occurs due to false therapy delivery during short circuit conditions
Solution Approach 1:
The patent performs preliminary detection of short circuit conditions by analyzing the electrogram signal before initiating high voltage therapy delivery, allowing the device to identify insulation breaches and prevent unnecessary therapy delivery that would waste battery energy
Solution Approach 2:
The patent uses the cardiac electrogram signal as feedback to continuously assess lead integrity, with the detected signal characteristics providing real-time information about short circuit conditions that informs subsequent therapy delivery decisions
Data Source
AI summary
An implantable medical device capable of sensing cardiac signals and delivering cardiac electrical stimulation therapies is enabled to detect a short circuit event. A signal is sensed by a sensing module coupled to electrodes. A controller detects a short circuit event in response to a slope of the sensed signal exceeding a short circuit threshold.